Lumbar Spine Movement Control Flashcards
1
Q
Lumbar stabilization intervention CPR criteria
A
- Age <40
- Avg. straight leg raise >91º
- Positive prone instability test
- Aberrant movement present (stability catch, painful arc, thigh climbing, reversal of limbo-pelvic rhythm
- NO sx distal to buttocks or signs of nerve root compression
2
Q
Lumbar spine stabilization patient looks like
A
- Younger
- Flexible
- Possibly athlete that trains primarily one way
3
Q
Treatment grades for spondylolisthesis & Scotty Dog Sign
A
- Grade I: usually not symptomatic
- Grade II: education to avoid extension & begin spinal stabilization; may use casting to reduce anterior shear forces & allow healing
- Grade IIII: conservative treatment may be attempted; surgery
- Grade IV: surgery due to neurological involvement
4
Q
What muscles have delayed activation in LBP patients
A
- Transverse abdominus (TRA) & multifidus
5
Q
Characteristics of the global dynamic stabilizers of the spine
A
- Superficial
- Cross multiple segments
- Motion & COM
- Compressive load when active
6
Q
List the global dynamic stabilizers of the spine
A
- Rectus abdominus
- External/internal oblique
- Quadratus lumborum (lateral)
- Erector spinae
- Illiopsoas
7
Q
Characteristics of the deep segmental dynamic stabilizers of the spine
A
- Deep
- Cross & attach to each vertebral segment
- Endurance: slow twitch type 1
8
Q
List the deep segmental dynamic stabilizers of the spine
A
- Transverse abdominus
- Multifidus
- Quadratus lumborum (deep)
- Deep rotators
9
Q
Describe the transverse abdominus
A
- Deepest abdominal muscle
- Attaches posterior to vertebra via thoracolumbar facia
- Develops tension to support
- Active in both isometric flexion & extension
- Responds to anticipatory & rapid UE/LE actions
- Links with the perineum, pelvic floor, & multifidi
10
Q
Describe the multifidus
A
- Control movements of segments & increase stiffness
- Encased in lumbodorsal fascia
- Moth eaten appearance & increased fatty infiltration in chronic LBP patient
11
Q
Hallmarks oof movement system impairment syndromes
A
- All people develop movement patterns as a strategy to perform any activity
- Pain from repetitive movement patterns that result in movement impairments: body takes path of least resistance; hyper mobility = tissues moving out of optimal range
- Improve by correction of movement impairment: treat cause not Sx, balance & precise movements, and train correct pattern & not isolated strengthening
12
Q
Define positional versus movement fault
A
- Positional: refers to a body structure that has become static
- Movement: refers to a learned movement pattern
13
Q
How to exam local mobility in sitting and standing
A
- Slump test
- Thoracic rotation
- Observe curvature, LEs alignment
- Pelvic static asymmetry
- Latissimus dorsi tightness (full shoulder flexion)
14
Q
How to exam global stability in sitting and standing
A
- Active knee extension
- Sit to stand test
- Spine ROM
- Thoracolumbar dissociation
- Lumbopelvic/hip dissociation
- Trendelenburg test
- Step up-down test
- Squat
15
Q
Causes of excessive lumbar extension
A
- Mobility (Latissimus)
- Stability (MC = movement control) lacks abdominal stability (allows lumbar extension too easily)
